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Table 1 Senge’s classification of challenges in organizational change

From: Mento’s change model in teaching competency-based medical education

The Challenges of Initiating:
 ➢ Not Enough Time – “We don’t have time for this stuff!”
 ➢ No Help (Coaching and Support) – “We have no help!” “We don’t know what we’re doing!”
 ➢ Not Relevant – “This stuff isn’t relevant!”
 ➢ Walking the Talk – “They’re not walking the talk!”
The Challenges of Sustaining
 ➢ Fear and Anxiety – “This stuff is _________.” (Am I safe? Am I adequate? Can I trust others? Can I trust myself?)
 ➢ Assessment and Measurement – “This stuff isn’t working!”
 ➢ True Believers – “They don’t understand us!” / “We have the right way!”
 ➢ Non-Believers – “I have no idea what these people are doing!”/ “They are acting like a cult!”
The Challenges of Redesigning and Rethinking
 ➢ Governance – “They won’t give up the power!”/ “Who’s in charge of this stuff!”
 ➢ Diffusion – “We keep reinventing the wheel!”
 ➢ Strategy and Purpose – “Where are we going? What are we here for?”